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White Matter Injury in Early Brain Injury after Subarachnoid Hemorrhage

Subarachnoid hemorrhage (SAH) is a major cause of high morbidity, disability, and mortality in the field of neurovascular disease. Most previous SAH studies have focused on improving cerebral blood flow, reducing cerebral vasospasm, reducing neuronal calcium overload, and other treatments. While the...

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Autores principales: Pang, Jinwei, Peng, Jianhua, Yang, Ping, Kuai, Li, Chen, Ligang, Zhang, John H., Jiang, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322133/
https://www.ncbi.nlm.nih.gov/pubmed/30442028
http://dx.doi.org/10.1177/0963689718812054
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author Pang, Jinwei
Peng, Jianhua
Yang, Ping
Kuai, Li
Chen, Ligang
Zhang, John H.
Jiang, Yong
author_facet Pang, Jinwei
Peng, Jianhua
Yang, Ping
Kuai, Li
Chen, Ligang
Zhang, John H.
Jiang, Yong
author_sort Pang, Jinwei
collection PubMed
description Subarachnoid hemorrhage (SAH) is a major cause of high morbidity, disability, and mortality in the field of neurovascular disease. Most previous SAH studies have focused on improving cerebral blood flow, reducing cerebral vasospasm, reducing neuronal calcium overload, and other treatments. While these studies showed exciting findings in basic science, therapeutic strategies based on the findings have not significantly improved neurological outcomes in patients with SAH. Currently, the only drug proven to effectively reduce the neurological defects of SAH patients is nimodipine. Current advances in imaging technologies in the field of stroke have confirmed that white matter injury (WMI) plays an important role in the prognosis of types of stroke, and suggests that WMI protection is essential for functional recovery and poststroke rehabilitation. However, WMI injury in relation to SAH has remained obscure until recently. An increasing number of studies suggest that the current limitations for SAH treatment are probably linked to overlooked WMI in previous studies that focused only on neurons and gray matter. In this review, we discuss the biology and functions of white matter in the normal brain, and discuss the potential pathophysiology and mechanisms of early brain injury after SAH. Our review demonstrates that WMI encompasses multiple substrates, and, therefore, more than one pharmacological approach is necessary to preserve WMI and prevent neurobehavioral impairment after SAH. Strategies targeting both neuronal injury and WMI may potentially provide a novel future for SAH knowledge and treatment.
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spelling pubmed-63221332019-01-14 White Matter Injury in Early Brain Injury after Subarachnoid Hemorrhage Pang, Jinwei Peng, Jianhua Yang, Ping Kuai, Li Chen, Ligang Zhang, John H. Jiang, Yong Cell Transplant Reviews Subarachnoid hemorrhage (SAH) is a major cause of high morbidity, disability, and mortality in the field of neurovascular disease. Most previous SAH studies have focused on improving cerebral blood flow, reducing cerebral vasospasm, reducing neuronal calcium overload, and other treatments. While these studies showed exciting findings in basic science, therapeutic strategies based on the findings have not significantly improved neurological outcomes in patients with SAH. Currently, the only drug proven to effectively reduce the neurological defects of SAH patients is nimodipine. Current advances in imaging technologies in the field of stroke have confirmed that white matter injury (WMI) plays an important role in the prognosis of types of stroke, and suggests that WMI protection is essential for functional recovery and poststroke rehabilitation. However, WMI injury in relation to SAH has remained obscure until recently. An increasing number of studies suggest that the current limitations for SAH treatment are probably linked to overlooked WMI in previous studies that focused only on neurons and gray matter. In this review, we discuss the biology and functions of white matter in the normal brain, and discuss the potential pathophysiology and mechanisms of early brain injury after SAH. Our review demonstrates that WMI encompasses multiple substrates, and, therefore, more than one pharmacological approach is necessary to preserve WMI and prevent neurobehavioral impairment after SAH. Strategies targeting both neuronal injury and WMI may potentially provide a novel future for SAH knowledge and treatment. SAGE Publications 2018-11-16 2019-01 /pmc/articles/PMC6322133/ /pubmed/30442028 http://dx.doi.org/10.1177/0963689718812054 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Reviews
Pang, Jinwei
Peng, Jianhua
Yang, Ping
Kuai, Li
Chen, Ligang
Zhang, John H.
Jiang, Yong
White Matter Injury in Early Brain Injury after Subarachnoid Hemorrhage
title White Matter Injury in Early Brain Injury after Subarachnoid Hemorrhage
title_full White Matter Injury in Early Brain Injury after Subarachnoid Hemorrhage
title_fullStr White Matter Injury in Early Brain Injury after Subarachnoid Hemorrhage
title_full_unstemmed White Matter Injury in Early Brain Injury after Subarachnoid Hemorrhage
title_short White Matter Injury in Early Brain Injury after Subarachnoid Hemorrhage
title_sort white matter injury in early brain injury after subarachnoid hemorrhage
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322133/
https://www.ncbi.nlm.nih.gov/pubmed/30442028
http://dx.doi.org/10.1177/0963689718812054
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